Hideki Ota MD, PhD, Presenter: Nothing to Disclose

Minako Oikawa MD, Abstract Co-Author: Nothing to Disclose

Morihiko Takeda, Abstract Co-Author: Nothing to Disclose

Satoshi Yasuda, Abstract Co-Author: Nothing to Disclose

Jun Takahashi, Abstract Co-Author: Nothing to Disclose

Yoshitaka Ito, Abstract Co-Author: Nothing to Disclose

Yoshihiro Fukumoto, Abstract Co-Author: Nothing to Disclose

Shuichi Higano MD, PhD, Abstract Co-Author: Nothing to Disclose

Hiroaki Shimokawa MD, PhD, Abstract Co-Author: Nothing to Disclose

Shoki Takahashi MD, Abstract Co-Author: Nothing to Disclose

To investigate associations between carotid vulnerable plaque (VP) detected by MR imaging and complexity of coronary artery disease (CAD) as determined by the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score.

Thirty-eight patients (men, 31, women, 7) with effort angina scheduled for coronary angiography were included. All the patients were asymptomatic for cerebrovascular ischemic disease. Subjects’ demographic data (sex, age, body mass index, hyperlipidemia, hypertension, diabetes mellitus and smoking) were collected. All the subjects underwent a bilateral carotid MR scan on a clinical 3.0T scanner with a two-channel surface coil. Multi-contrast carotid MR imaging protocol included 5 different weightings (T1W, contrast-enhanced T1W, T2W, time-of-flight and magnetization prepared rapid acquisition with gradient echo images) to characterize carotid plaques. Presence of carotid VP (plaques with luminal surface defect, intraplaque hemorrhage, and/or calcified nodules) and maximal carotid wall thickness were documented. Based on coronary angiogram, the number of major coronary arteries with significant stenosis and the SYNTAX score were also documented. A linear regression analysis was used to examine associations among the findings of carotid MRI and coronary angiogram adjusting for subjects’ demographic data as potential confounder.

Out of 38 patients, carotid VP was found in 16 (42%). The mean number of diseased coronary arteries was 2.2 ± 0.9. The mean of SYNTAX score was 23.4 ± 11.5. In multiple stepwise linear regression analysis, the presence of carotid VP (coefficient=8.2, 95% confidence interval (CI) =2.1, 14.5, p=0.01) and diabetes mellitus (coefficient=11.7, 95%CI=5.3, 18.1, p<0.01) was positively associated with SYNTAX score. Carotid VP was also associated with the higher number of diseased coronary arteries (p<0.01). Maximal carotid wall thickness (p=0.54) was not significantly associated with the SYNTAX Score.  

These results indicate that carotid VP detected by MR imaging may become a marker of the complexity of CAD and multivessel CAD.

Carotid plaque MR imaging can identify vulnerable plaque and is recommended as an non-invasive tool to evaluate the severity of athrosclerosis for patients with coronary artery disease.

Ota, H, Oikawa, M, Takeda, M, Yasuda, S, Takahashi, J, Ito, Y, Fukumoto, Y, Higano, S, Shimokawa, H, Takahashi, S, Carotid Vulnerable Plaque Identified by 3.0 T MR Imaging Is Associated with the Complexity of Coronary Artery Disease in Patients with Angina.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006781.html